News & Information
Medicaid Directors Question Need for $1,000 HCV Pill
Written by Editor   
Wednesday, May 28, 2014 08:26 AM

Under the "wow" category of news add this report:

The evidence base for one of the star hepatitis C drugs is poor and the guidelines for its use are flawed, according to a report prepared for the National Association of Medicaid Directors.  According to the report, studies of sofosbuvir (Sovaldi) are generally of poor quality, mostly directed by the drug's maker, and don't answer key questions, including whether the drug is better and safer than the current standard of care.  The only available guidelines for its use -- guidelines created by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America -- are "methodologically flawed," according to the report, which was prepared by the Center for Evidence-Based Policy at Oregon Health and Science University in Portland.  In addition, their authors and sponsors had "multiple and significant conflicts of interest," the report argued.

Sofosbuvir is widely regarded as the leading edge of a new wave of hepatitis C virus (HCV) drugs which promise routine cures for what is now a difficult-to-treat and costly illness.  But the drug has been controversial because Gilead has set the price high — $1,000 a pill. The drug is taken once daily and a course of treatment can last 12 or 24 weeks — $84,000 or $168,000, respectively.  The total cost would be higher, since other drugs must be used and treatment monitored carefully.

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MDs Among Top Five Coding Abusers
Written by Editor   
Wednesday, May 28, 2014 08:09 AM

When people think of seeing a doctor, generally the first thing that comes to mind is an office visit. But not all visits are the same.  Doctors get paid more for more complex visits. Office visits for established patients are billed across five levels.  Three California Medical Doctors are among the top five nationally in billing for the most complex office visits, according to data released by Medicare.  

Most doctors' billing patterns to the Medicare program fall in the middle ground between simple and complex.  In California, only 5% of doctors' office visits for Medicare patients were billed at the highest level in 2012. It is unusual for doctors to determine -- and bill -- a large proportion of their office visits as complex.  The analysis of Medicare billing data -- which was made public for the first time last month -- shows that three California doctors are among the top five nationally in billing for the highest number of the most complex office visits. In addition, they tended to bill at the highest level significantly more frequently than peers in their specialty.

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VA Top Doc Calls It Quits
Written by Editor   
Monday, May 19, 2014 08:14 AM

Robert Petzel M.D., the man in charge of healthcare for the Department of Veterans Affairs (VA), resigned Friday in the wake of a growing scandal over the care provided to veterans at various VA healthcare facilities.  According to CNN, at least 40 veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system in Arizona. Many patients were placed on a secret waiting list, the news outlet's sources said.

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Steroid Use in RA More Common than 20 Years Ago
Written by Editor   
Monday, May 19, 2014 08:07 AM

More patients with rheumatoid arthritis today are initiating treatment with glucocorticoids (GCs) early in the course of disease than was the case 20 years ago, a retrospective study found.

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Medicare Pays Billions for 'Low-Value Care'
Written by Editor   
Tuesday, May 13, 2014 12:39 PM

The Medicare system spent at least $1.9 billion in 2009 and probably much more on "low-value" procedures and tests, such as cancer screening in patients with end-stage renal disease in patients 75 and older, researchers said.  Depending on whether relatively sensitive versus specific measures of low-value care were used, the percentage of overall Medicare Parts A and B spending that went to such services ranged from 0.6% to 2.7%.

Although these figures represented "modest proportions" of the total Medicare budget, the researchers wrote; from one-quarter to more than 40% of all beneficiaries received at least one of the 26 types of low-value service during the 1-year study period.

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